Call for major changes to fitness to drive testing


The newly released edition of truckies’ medical standards, Assessing Fitness to Drive, falls short of the safety requirements the industry needs, says the National Road Transport Association (NatRoad).

The joint publication of Austroads and the National Transport Commission (NTC) details the medical standards for driver licensing for use by health professionals and driver licensing authorities.

But NatRoad advisor Richard Calver says the updated 2022 guidelines that now play a major part in dictating the safety and wellbeing of all road users are still well short of where they need to be for the heavy vehicle industry.

“They cleaned up some of the language and the standards have been slightly altered but we wanted far more fundamental change,” said Calver.

“We wanted the fitness to drive guidelines to be seriously reformed. We want them to be objective national fitness to drive standards, which incorporate more fit-for-purpose screening.”

In their current format, Calver said the guidelines used around Australia are not adequate for determining if an individual is fit to drive a commercial vehicle.

“We want more medical disclosure and reporting of conditions that affect the driving task and more consistent medical reporting and associated licensing requirements,” he said.

As an example, Calver cited the current screening approach used for sleep disorders, the Epworth Sleepiness Scale, a subjective questionnaire that helps doctors determine if a truckie has sleep apnoea. A peer-reviewed article published in the Australian medical research journal SLEEP found that 41 per cent of drivers may have undiagnosed obstructive sleep apnoea.

“So, the patient fills in the survey before the medical examination, and then there’s a score. If it’s 16 or more, it can be consistent with moderate or severe excessive daytime sleepiness, but it’s then the doctor’s call,” said Calver.

Calver said NatRoad would like to see the industry adopt rail’s more objective approach in which a doctor screens the driver using a flowchart system that determines whether a driver then needs to be sent for a sleep study.

“If a driver then uses a CPAP [continuous positive airway pressure] machine and reports that they’ve used that they can continue driving even though that might be an older driver. So, you’re actually intervening to assist, you’re not intervening to exclude.”

NatRoad has also called for the same objective screening tests for type-two diabetes, psychiatric illness and cardiac health.

“And there should be a link between fitness to drive and the Heavy Vehicle National Law (HVNL),” added Calver.

“There could be a number of different ways that’s linked, but having minimum driver health checks helps them [truckies] and the industry.

“The current state and territory licensing requirements, they only mandate what you could call minimum competencies and medical fitness that fall short of the health screening that our members have wanted for some considerable time.”

The NTC undertook consultation rounds in September 2020 and May 2021 requesting stakeholder feedback on the 2016 version of Assessing Fitness to Drive and the proposed 2022 update, respectively.

All up the commission received over 70 submissions raising 600 matters it considered in developing the revised guidelines.

But Calver said that when NatRoad queried why it’s call for objective testing was largely ignored, they were told it wasn’t with the scope of the review terms the NTC had from the government.

“Having arguments about scope is a bit like walking through a desert, it doesn’t get anyone anywhere.”

Calver said that NatRoad is now hoping its proposed changes are adopted as part of the revised HVNL with commercial driving standards that are separate for the heavy vehicle industry rather than lumped in with all drivers under the current system.

“The detail of that doesn’t really matter at this point, so long as they re-examine the fitness to drive standards with a view to making as many objective screening tests along the lines of the rail safety standard, incorporated into those guidelines.”

In its submission to the NTC, the Australian Trucking Association (ATA) didn’t support separating private and commercial standards but did say the latter should be improved to include objective screening tests for sleep apnoea, diabetes and cardiac risk level.

More recently the ATA also called for mandatory medicals for all heavy vehicle drivers against fit for purpose medical standards in its 2022 Policy Charter.

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